The primary outcome was that no patients who were treated with naloxone for opioid overdose and then refused care were examined by the MEO within a 48-hour time frame.

The Accreditation Council for Graduate Medical Education (ACGME) has challenged residency programs to provide documentation via outcomes assessment that all residents have successfully mastered the six core competencies. A variety of assessment "tools" has been identified by the ACGME for outcomes assessment determination. Although rarely cited in the medical literature, 360-degree feedback is currently in widespread use in the business sector. This tool provides timely, consolidated feedback from sources in the resident's sphere of influence (emergency medicine faculty, emergency medicine residents, off-service residents and faculty, nurses, ancillary personnel, patients, out-of-hospital care providers, and a self-assessment). This is a significant deviation from both the peer review process and the resident review process that almost exclusively use physicians as raters. Because of its relative lack of development, utilization, and validation as a method of resident assessment in graduate medical education, a great opportunity exists to develop the 360-degree feedback tool for resident assessment.

Survival to hospital discharge after OHCA is rare without field ROSC. Resuscitation efforts should focus on achieving field ROSC. Transport should be reserved for patients with field ROSC or a shockable rhythm.